The goal of this five-year training award is to further Dr. David Folsom's development as an independent intervention and health services researcher. He will develop specialized expertise in the psychiatric and medical care of individuals with serious mental illness (SMI), particularly homeless individuals. This career development plan also will build on Dr. Folsom's training in psychiatry and family medicine, on his clinical experience in providing psychiatric and primary care to homeless persons with mental illnesses, and on his current research in homelessness and healthcare for people with schizophrenia. Dr. Folsom completed the combined Psychiatry-Family Medicine Residency Program at UCSD, where his outpatient training for both specialties took place in the medical clinic of a homeless shelter. Currently, he is Assistant Clinical Professor in the Department of Family and Preventive Medicine at UCSD, and a psychiatry research fellow at the San Diego VA. Dr. Folsom has authored or co-authored five articles that are published or in press, and he has presented abstracts or papers at five national meetings focusing on homelessness and healthcare for people with schizophrenia. The goal for his research career development award is to become a health services researcher with special expertise in improving medical and psychiatric care for homeless patients with serious mental illness. The specific goals for this career development award are: 1. To gain knowledge and experience in effectiveness and interventions research, with a specific focus on homeless persons with mental illness; 2. To design, refine and test patient level interventions that integrate medical and psychiatric care for homeless persons with SMI; 3. To become proficient at research design, methodology, and quantitative data analysis. This training plan includes structured coursework that will lead to an MPH degree. The training plan will also include mentorship and consultation with experts in the following areas: community based interventions, mental health services research, psychiatric and medical care for homeless persons and integration of psychiatric and medical treatment. Dr. Folsom's hands-on research training will consist of a small, randomized controlled trial, which will test the effectiveness of a nurse case manager intervention on improving the health and reducing the disability of homeless persons with schizophrenia.